The importance of social support has been recognized for both the development and progression of a variety of medical disorders. Yet, neither the content of social support nor its impact on terminal care has been carefully studied. Currently, there are few systematic approaches to the development and evaluation of social support programs for terminal cancer patients. Furthermore, well meaning individuals, even when available, may not know how to provide or may have great difficulty undertaking support of a dying person. We will undertake a prospective study of the role of social support in the psychosocial adaptation of terminal lung cancer patients. We have the capability of following a sufficient number of such patients representing different levels of social support. Patients will be compared across three levels of support: Intermittent social service involvement, ongoing individual support usually by a spouse, and ongoing individual support plus regular professional counselling supplied to the supporting individual. We will employ standardized psychological assessments whenever possile. Data will be supplemented by semistructured interviews given by trained clinicians. Support counselling will be monitored to help standardize the intervention. Approximately 180 patients will be evaluated every 6 weeks from the time of diagnosis to death. The duration of the study will be 3 years. If patients whose supporters receive counselling show better adaptation, this information is relevant for future terminal care programs. We intend to follow the impact of support counselling on the adjustment of the individual supporters after the patient's death.